645 OCEAN BLVD - GAS PIPING 'r j 1.���J rJ J'i::I' / °� CITY OF ATLANTIC BEACH
J 800 SEMINOLE ROAD
JV
J r ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
MECHANICAL GAS PIPE PERMIT
MUST CALL BY 4PM FOR NEXT DAY INSPECTION: 247-5814
JOB INFORMATION:
Job ID: 16-MCHG-1677
Job Type: MECHANICAL GAS PIPING
Description: 250 tanks, 2 water heaters, 1 gas piping outlet, 5 other outlets.
Estimated Value: $4,500.00
,, Issue Date: 7/26/2016
Expiration Date: 1/22/2017
PROPERTY ADDRESS:
Address: 645 OCEAN BLVD
RE Number: 170126-0000
PROPERTY OWNER:
Name: LACKIE, RAYMOND & AUDREY. *
Address: 1300 FLORIDA BLVD
GENERAL CONTRACTOR INFORMATION:
Name: AA BOTTLED GAS COMPANY INC
Address: 12601 N MAIN ST EDDIE GENE THIGPEN
Phone: - -
FEES:
Gas Piping Units $0.00
Gas Piping Vented Units $10.00
State Mech DBPR Surcharge $2.00
Trade Permit Base Fee $55.00
State Mech DCA Surcharge $2.00
Total Payments: $69.00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
MECHANICAL PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Rd Atlantic Beach, FL 32233
Ph (904) 247-5826 Fax (904) 247-5845
JOB ADDRESS: (e(-46.-
el age)/1 /Vd 34z,3 3 PERMIT# I
6'9"6 -1677
PROJECT VALUE $ , 690 • °v ARI# REQUIRED
Air Handling Equipment Only Air Handling Unit & Condenser Condenser Only
NEW AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
REPLACEMENT AIR CONDITIONING & HEATING SYSTEM INSTALLATION
Air Conditioning: Unit Quantity Tons Per Unit
Heat: Unit Quantity BTU's Per Unit Seer Rating
Duct Systems: Total CFM REQUIRED
FIRE PREVENTION
Fire Sprinkler System Quantity (Requires 3 sets of plans)
Fire Standpipe Quantity (Requires 3 sets of plans)
Underground Fire Main Value (Requires 3 sets of plans)
Fire Hose Cabinets Quantity (Requires 3 sets of plans)
Commercial Hoods Quantity (Requires 3 sets of plans)
Fire Suppression Systems Quantity (Requires 3 sets of plans)
FIRE PLACES MISCELLANEOUS:
Prefabricated Fireplace Qty / Automobile Lifts
Gas Piping Outlets _.__L_ Boilers BTU's
Elevators/Escalators
ALL OTHER GAS PIPING Heat Exchanger
Quantity of Outlets 5 Pumps
#Vented Wall Furnaces --- Refrigerator Condenser BTU's
Ig # Water Heaters 2.. Solar Collection Systems
Tanks (gallons) ,7..IV
Wells
OTHER:
Permit becomes void if work does not commence within a six month period or work is suspended or abandoned for six months. I hereby certify that I have read
this application and know the same to be true and correct. All provisions of laws and ordinances governing this work will be complied with whether specified or
not. The permit does not give authority t to the rovisions of an o her state or local law regulation construction or the performance of construction.
��. '
Property Owners Name /L 12J1O!OOPhone Number
Mechanical Company MI -a`C I &LS ffice Phone 75 7-/'Z4
x 7�7-0&2s"
Co. Address: �0/ /�lOY�t i l 51ve- Cityji-rd-Soiet ✓//k
040t to Zip (.3 -,W6
License Holder(Print): ( 1-4(a. C 0 /. , .tate Certification/Registration# /41-45/.3
Notarized Signature of License Holder /1' '
efore me this .. � day of
,R''' *', TIFFANY C.ROWE ��i+
:•• `•_. MY COMMISSION#EE84018 'ignature of Notary Public, _J,' -
• ''t' EXPIRES October 02,2016 V
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